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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 631 records · Page 35Linked to original sources
PubMed2004

Home enteral feeding audit.

OBJECTIVE: To determine the main problems that families experience in the first month after their child is discharged from hospital on home enteral tube feeds (HETF) in terms of obtaining feed and equipment, managing tube feeding and accessing health professionals. METHODS: A multiple choice/short answer questionnaire was used to interview 81 parents/carers of children aged 0-16 years discharged from a supra regional children's hospital on HETF for the first time between December 2001 and August 2003. Questions addressed issues such as: contact with the home delivery company (HDC); delivery of feed and equipment; training; ability to access help; illnesses associated with tube feeding; and understanding of procedures post-discharge. RESULTS: The main problems identified were: delayed first deliveries (> or =7 days post-discharge; 47%); equipment missing from the first delivery (41%); difficulty obtaining a prescription from the general practitioner (GP) (17%); changing to different equipment post-discharge with minimal training on the new equipment (26%). CONCLUSIONS: There were many problems with delays in delivery of equipment, incorrect equipment and changing of equipment when patients were first discharged on HETF. Significant improvements are necessary in organization of home enteral feeding systems when patients are first discharged.

Adolescent↗
PubMed2004

A Meaningful Day Group approach to weight gain from antipsychotic medication.

For clients who receive medical treatment for a severe and enduring mental health problem, antipsychotic medication is the first line of treatment. The adverse effects of these medications are well documented and can lead to discontinuation of therapy. The newer atypical antipsychotics would seem to have distinct advantages over more traditional substances but significant weight gain can be experienced. This group is an attempt to capitalize upon psychosocial approaches to this such that outcome may be enhanced. The following is a description of an attempt to implement such a group and to explore the outcome. The group has been devised by one of the manufacturers of atypical antipsychotic medication concerned by the side-effect to their product. The group is formatted on a computer disc ready to use by any mental health professional and freely available.

Antipsychotic Agents↗
PubMed2007

Critique of Falloon and the Optimal Treatment Project.

The Optimal Treatment Project advocated by Falloon has been demonstrated through the scientific research literature to be efficient and effective treatment strategies for people experiencing severe mental illness. For this reason, there is little critique of this approach. While the potential value of the project is acknowledged, it is important to identify the appropriateness of the model for specific services and to understand comprehensively the resources necessary for successful implementation. The aim of this paper is to review the literature in relation to the Optimal Treatment Project with a view to exploring the complexities associated with the model. It is concluded that the involvement of multiple stakeholders, including consumers of mental health services, should become an essential element of any implementation strategy.

Antipsychotic Agents↗
PubMed2004

A review of the literature on care of clients in pain who are culturally diverse.

AIM: This article reviews the literature on the care of clients from diverse cultures who are in pain and provides strategies for care. BACKGROUND: Pain is a critical concept for caring for clients and particularly for clients from another culture. Culture shapes the values, beliefs, norms, and practices of individuals, including the ways persons react to pain. Culture affects the assessment and management of pain. CONCLUSIONS: Seven strategies can assist in culturally appropriate assessment and management of pain: (1) utilize assessment tools to assist in measuring pain, (2) appreciate variations in affective response to pain, (3) be sensitive to variations in communication styles, (4) recognize that communication of pain may not be acceptable within a culture, (5) appreciate that the meaning of pain varies between cultures, (6) utilize knowledge of biological variations, and (7) develop personal awareness of values and beliefs which may affect responses to pain.

Attitude to Health↗
PubMed2005

Just-in-time evidence-based e-mail "reminders" in home health care: impact on patient outcomes.

OBJECTIVE: To assess the impact and cost-effectiveness of two information-based provider reminder interventions designed to improve self-care management and outcomes of heart failure (HF) patients. DATA SOURCES/STUDY SETTING: Interview and agency administrative data on 628 home care patients with a primary diagnosis of HF. STUDY DESIGN: Patients were treated by nurses randomly assigned to usual care or one of two intervention groups. The basic intervention was an e-mail to the patient's nurse highlighting six HF-specific clinical recommendations. The augmented intervention supplemented the initial nurse reminder with additional clinician and patient resources. DATA COLLECTION: Patient interviews were conducted 45 days post admission to measure self-management behaviors, HF-specific outcomes (Kansas City Cardiomyopathy Questionnaire-KCCQ), health-related quality of life (EuroQoL), and service use. PRINCIPAL FINDINGS: Both interventions improved the mean KCCQ summary score (15.3 and 12.9 percent, respectively) relative to usual care (p< or =.05). The basic intervention also yielded a higher EuroQoL score relative to usual care (p< or =.05). In addition, the interventions had a positive impact on medication knowledge, diet, and weight monitoring. The basic intervention was more cost-effective than the augmented intervention in improving clinical outcomes. CONCLUSIONS: This study demonstrates the positive impact of targeting evidence-based computer reminders to home health nurses to improve patient self-care behaviors, knowledge, and clinical outcomes. It also advances the field's limited understanding of the cost-effectiveness of selected strategies for translating research into practice.

Adult↗
PubMedDate not supplied

Managing anxiety in ICU patients: the role of pre-operative information provision.

Hospital-induced patient anxiety and coping mechanisms are discussed. The value of giving pre-operative information to reduce anxiety in elective admissions to intensive care unit is discussed. Recommendations are given based on the literature evidence to aid service and practice development.

Adaptation, Psychological↗
PubMed2003

Bridging the treatment gap: improving compliance with lipid-modifying agents and therapeutic lifestyle changes.

Despite the large burden of cardiovascular disease on society, abnormal lipid levels, which are associated with an increase in coronary heart disease mortality, are not being adequately managed in many individuals. Poor patient compliance with therapeutic lifestyle changes and lipid-modifying therapies contribute to this treatment gap. If management of lipid levels is to reduce cardiovascular mortality effectively, poor compliance with treatment needs to be understood and addressed. Educating and motivating patients to understand the need for compliance with continued therapy is an important step for ensuring that the benefits of lipid management cited in clinical trials are translated to the general population. This will require a proactive approach from both patients and physicians. Well-tolerated and effective therapies may also help compliance by reducing the incidence of side effects and the need for complex dosing regimens. Suboptimal treatment of lipid levels is currently limiting the effectiveness of primary and secondary prevention of coronary heart disease; methods for improving compliance should be a key strategy to overcoming this problem.

Cardiovascular Diseases↗
PubMed2005

Epidemiology of diabetic nephropathy in Spain.

BACKGROUND: The incidence of diabetes mellitus (DM) has increased persistently in recent years and is becoming an epidemic. Some have estimated that 4.4% of the world's population will be diabetic by the year 2030. The increase incidence of DM has been accompanied by an increased incidence in diabetic nephropathy (DN), the main cause of end-stage renal disease. METHODS AND RESULTS: In 1996, a pharmaco-economic study estimated that 162,000 people in Spain had type 1 DM and 1,354,900 had type 2 DM. More recent studies have estimated that 6% to 10% of the Spanish population might be diabetic. This percentage is higher in some autonomous communities, such as Canarias, in which 12% of the population is thought to have DM. Based on these studies, we estimate that more than 33,000 residents of Canarias have DN associated with type 1 DM, and more than 405,000 have DN associated with type 2 DM. The percentage of diabetic patients starting renal replacement therapy each year is currently around 21% in Spain but much higher (35%) in Canarias, which equates to 78 patients per million population (pmp) per year. In Catalonia, the number of DM patients entering renal replacement therapy has increased from 8.6 pmp per year in 1984 to 32.4 pmp per year in 2003. We estimate that the systematic application of converting enzyme inhibitors or angiotensin receptor blockers could save more than 2.690 million over 15 years in Spain. CONCLUSION: This epidemic could be prevented, or its impact reduced, through multifactorial and multidisciplinary early intervention, under the observance of guides, Spanish consensus documents, and clinical practice recommendations, together with an integrated educational program aimed at people with diabetes and the improvement of the standard of medical care.

Data Interpretation, Statistical↗
PubMed2005

Cardiovascular abnormalities and arrhythmias in patients with Ondine's curse (congenital central hypoventilation) syndrome.

Patients with congenital central hypoventilation syndrome (CCHS) (Ondine's curse syndrome) have impaired autonomic control of ventilation with intact voluntary control of respiration. Autonomic dysfunction and cardiac abnormalities are common in CCHS. Bradyarrhythmias are life-threatening and often require pacemaker insertion. We presented a case of a patient with CCHS suffering from long sinus pauses requiring cardiac pacemaker insertion. Patients with CCHS are at risk for pulmonary hypertension and cor pulmonale secondary to chronic hypoxia. Diaphragmatic pacing has been beneficial in some patients with CCHS. In this article, we review concomitant cardiac abnormalities and the occurrence of bradyarrhythmias in patients with CCHS.

Arrhythmias, Cardiac↗
PubMed2005

Ablation of idiopathic right ventricular outflow tract tachycardia: current perspectives.

Ventricular tachycardia (VT) arising from the right ventricular outflow tract (RVOT) in the absence of overt structural heart disease is a common entity. Exclusion of occult structural disease such as arrhythmogenic right ventricular cardiomyopathy is critical as this diagnosis impacts both ablation outcomes and long-term prognosis. VT is most commonly due to triggered activity. Induction of the target arrhythmia in the laboratory is often problematic, and is frequently facilitated by catecholamine infusion. Recent data indicate that high-density three-dimensional activation mapping facilitates identification of target sites for ablation, and that the spatial resolution of pacemapping may be more limited than previously recognized. A standard 12-lead electrocardiogram is useful in providing an initial approximation of the site of origin within the outflow tract, and may contain subtle clues to potentially confounding foci on the left ventricular endocardial or epicardial surface. When sufficient arrhythmia is present to permit mapping, successful ablation can be expected in 90-95% of patients, with a recurrence risk of approximately 5%. In experienced centers, major complications are <or=1% and outcomes should approach those obtained for the common forms of supraventricular tachycardia.

Catheter Ablation↗
PubMed1997

The combat of non-compliance during prophylactic lithium treatment.

Non-compliance is the most frequent cause of recurrence during prophylactic lithium treatment and is associated with poor response and high levels of suicidality. Non-compliance is a complex phenomenon and may have a number of causes. When manic-depressive patients fare badly under the conditions of so-called 'naturalistic' trials, this usually indicates that such conditions are inadequate for long-term maintenance treatment. Prophylactic lithium treatment must be accompanied by measures to sustain compliance and counteract drop-out, and these measures build on three cornerstones, namely information, support and supervision.

Aftercare↗
PubMed2006

Ethics and pharmaceutical medicine -- the full report of the Ethical Issues Committee of the Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the UK.

The practice of pharmaceutical medicine brings with it ethical challenges and dilemmas often very different from those encountered in the practice of clinical medicine. Having established a framework of guiding ethical principles, this report aims to look in some detail at specific areas of possible ethical concern to pharmaceutical physicians, offering practical advice and guidance on good practice. The report covers issues related to pharmaceutical research, including dissemination of research findings, communication with other health professionals and patients and involvement of pharmaceutical physicians and companies in the provision of patient services. The primacy of the interests of patients and the wider public is emphasised, and the possible impact of new developments in pharmaceutical technology is explored. It is hoped that the report will help those working in pharmaceutical medicine and act as a stimulus for wider discussion and debate.

Biomedical Research↗